This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, October 12, 2015

Weekly Australian Health IT Links – 12th October, 2015.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

A quiet week until Friday afternoon when we heard about the ‘start-up’ committee for the ACeH and absolutely zero about what it would do, by when etc.

Health Minister Sussan Ley today named the inaugural members of the eHealth implementation taskforce steering committee, which will be chaired by chief executive of the National Mental Health Commission Robyn Kruk.

Paul Madden was until recently the CIO of the federal Department of Health, and has been at the forefront of the push for personally controlled electronic health records since the program was originally funded in 2010.

An opt-out system could arrest continued low engagement with the government’s My Health system. The deputy secretary in charge says having critical mass will help convince providers to engage too.

Australia’s progress towards a widely subscribed national ehealth system remains slow, with only around 10% of the population enrolled with the government’s opt-in My Health Record system and low uptake by health practitioners.

Due to low engagement rates following its creation as an opt-in system in 2012, the Health Department plans to recommend the government adopt an opt-out policy from 2017, Department of Health deputy secretary and strategic health systems and information management special adviser Paul Madden told a Committee for the Economic Development of Australia event last week.

Health Reporter

Nathan Attard was methodical and determined in the way he went about obtaining prescription medicine.

In the 12 months before his death, he saw 22 different doctors and obtained 75 scripts for benzodiazepines and drugs containing opioids.

During the inquest into his 2012 death from multi-drug toxicity, an independent expert observed he had "worked out a system that enabled him to obtain the medicines that he was looking for, without actually triggering alarm bells for anybody".

Although doctors and pharmacists keep their own records, no states or territories outside Tasmania have centralised electronic systems that capture in real time which controlled drugs have been prescribed and dispensed to individual patients.

Pharmacists and doctors have teamed up to complain about the “extremely slow” roll-out of a national system to efficiently monitor the prescribing and dispensing of controlled drugs.

Funding for the system, known as Electronic Recording and Reporting of Controlled Drugs (ERRCD), was approved in the 2010 5CPA negotiations, but so far only Tasmania has implemented it.

Now the Pharmacy Guild of Australia, PSA and the SHPA have teamed up with the AMA, RACGP and other organisations to write a joint letter to Federal Health Minister Sussan Ley and her state and territory counterparts.

THE TGA will investigate the safety and ethics of a new telephone-based service providing access to medical abortions.

The service, provided by the Tabbot Foundation, is offered in the first 63 days of pregnancy for women living within an hour’s travel of an emergency medical facility.

“The Commonwealth Department of Health is considering the implications of this arrangement on the health and wellbeing of women in the context of the access provided by telehealth consultations,” a departmental spokeswoman says.

Also to be examined by the TGA is whether telephone-mediated pregnancy termination complies with the authority required by prescribers to offer mifepristone and misoprostol (MS-2 Step, Linepharma) under the PBS and the guidelines for dispensing pharmaceuticals by mail.

Current guidelines and industry standards suggest that new EHR software should be tested by at least 15 end users with a clinical background to make sure they are usable and safe before they get federal certification.

But a new study finds that many certified products did not actually conduct this user testing, or did so without clinical testers.

Despite the guidelines, “there’s no explicit requirement for end user testers to have a clinical background,” said Raj M. Ratwani of MedStar Health in Washington, D.C., who worked on the study.

A review of the PCEHR system (PCEHR Review) was undertaken in 2013. It found that there was overwhelming support for continuing implementation of a nationally consistent electronic health record system for all Australians, but that a change in approach was needed to correct early implementation issues. The PCEHR Review made thirty-eight recommendations aimed at making the system more usable and able to deliver the expected benefits in a shorter period. The recommendations include establishing new governance arrangements, moving to an opt-out system for individual participation, and improving system usability and the clinical content of records.-----

Australian GPs are suffering from ‘guideline overload' and want more succinct clinical practice guidelines that are easier to access, research shows.

Almost all GPs want clinical guidelines to be presented as one-page checklists, flowcharts or 2-3-page summaries, with only 1% preferring detailed manuals, a survey of 79 GPs from NSW and SA has found.

Many respondents complained that clinical guidelines were too hard to find and suggested that they should be incorporated into practice software to make them more accessible.

"The problem with guidelines in general practice is that one GP could never know all the guidelines, and the field is too vast," one GP told the researchers from the University of SA and the University of Sydney.

Learning health systems are the next big thing. Through the use of information technology, the hope is that we can analyse all the data captured in electronic health records to speed both the process of scientific discovery and the translation of these discoveries into routine practice1,2. Every patient’s data, their response to treatment, and final outcome, will no longer be filed away, but feed the care of future patients3. It’s an exciting vision, and if we can achieve it, there is no doubt healthcare delivery would be transformed.

If we were to step back, we might conclude that although this is an admirable vision, for all its failings, the machinery of science is already working faster than we can handle it. The arena where organizational learning most needs to take hold is in the way we deliver health services. It is clear that we could do so much better in this arena. There is too much variation in patient care, too much waste and harm in the system.

CIO role up for grabs after five-year wait.

WA Health has finally begun taking applications for a chief information officer role that has remained in the hands of temporary appointees since 2010.

On Saturday the department posted a job ad seeking candidates to become CIO of the 43,000-strong department on a five year contract.

The recruitment drive follows a five-year revolving door at the top of WA Health's IT wing, the health information network (HIN), which has been linked by some parliamentarians to the government’s failure to commission IT services at the new Fiona Stanley Hospital on time.

Carl Leonard, principal security analyst for Websense, said healthcare around the world is now experiencing 340% more attacks than the average industry sector. He said that, in 2014, there was a phenomenal 600% increase in the number of attacks launched against hospitals – and Australia is no exception.

Author

David Glance Director of UWA Centre for Software Practice, University of Western Australia

The heart rate measurement feature in the Apple Watch was intended as an aid to those using the device during exercise sessions. For a teenage boy it proved a lifesaver as a high heart rate reading prompted him to seek medical help which led to the discovery that he was suffering from a condition called rhabdomyolysis which can lead to kidney damage.

Since teenager Paul Houle’s story, similar incidents have been reported of people seeking help on noticing abnormal heart rates being measured by their watch. Australian journalist Gary Barker acted immediately on seeing his Apple Watch report his heart rate behaving erratically and spiking between 50 and 150 beats a minute. The irregular heart beat was later diagnosed as being caused by atrial fibrillation, a condition that can lead to heart failure and stroke.

ACCORDING to research done at the Stanford Medical School, there can be reluctance among doctors to discuss end-of-life wishes with their patients.

We acknowledge the importance of being aware of an individual’s wishes, however it too often gets passed over during consults and not thought of until it is too late. The Stanford Medical School has developed the Stanford Letter Project to help facilitate these discussions.

On opening the app, the user is guided to choose a language. Once chosen there are a series of prompts to cover the key decisions for end-of-life care.

Biomedical staff at Royal Hobart Hospital are receiving training on advanced medical equipment from clinicians in other parts of Australia under a new telepresence system trial.

Royal Hobart Hospital is a large tertiary referral centre that is geographically isolated and education and support for its biomedical staff is limited, said the hospital's specialist anaesthetist, Dr Savas Totonidis.

“We have all the advanced equipment and naturally are expected to perform at the same level as our mainland counterparts; the critical difference for us is training,” he said.

A privacy breach, which has seen the unauthorised release of confidential birth and death details of over 24,000 Kiwis, has been branded “inexcusable” by the Labour Party.

As reported by the New Zealand Herald;officials are investigating how a spreadsheet of National Health Index (NHI) numbers, containing the birth and death dates of 24,092 people, was emailed to around 950 pharmacists yesterday morning. The email was supposed to be sent internally.

Following the revelations, Labour’s Health spokesperson Annette King has claimed the Ministry of Health’s blunder, “is shocking, whether unintentional or not.”

“Patients must be able to trust the information they give to doctors will only be accessible to staff involved in their treatment,” King claims.

Mental health care is not accessible to everyone. It’s a fact that less than fifty percent of people who need treatment actually get it. But access to an internet connection is available to most people. So it makes sense to offer more health services online.

Although the opinions are divided about Dr Google, health experts now agree on one thing: internet therapy for many mental health problems works.

5 benefits

E-mental health is a broad term used for mental health services delivered via internet programs, telehealth, mobile phone applications and websites. There are five benefits:

Telemedicine programs are often designed to meet the needs of specialists rather than rural doctors

Australia has almost twice as many small rural hospital-based emergency facilities as designated emergency departments.1 They see 16% of Australia’s emergency patient presentations, or almost 1.3 million presentations each year.1 Although small rural facilities are tasked with managing mainly minor injury and illness, they also treat patients with complex and time critical problems.2 These facilities are staffed by nurses alone, or by junior doctors, general practitioners or rural generalists. Rural doctors often have specific training for rural emergency medicine, and they usually have more years of experience than junior doctors who treat most patients in urban emergency departments. What they lack is immediate access to onsite specialist advice.

Tertiary specialty units that receive patients from rural areas are often aware of this deficit. Concerned about the poor outcomes for their rural patients (although rural–urban outcome research is often confounded by hard-to-control-for factors3), some have created systems to provide a lifeline for early advice and support. A recent systematic review4 described tele-emergency programs that provide support for stroke thrombolysis, trauma management, burns care, eye conditions and several other specific problems.

Author Stephen Duckett

Director, Health Program, Grattan Institute

Australia’s new prime minister, Malcolm Turnbull, has announced what he calls a “21st-century government”. This article is part of The Conversation’s series focusing on what such a government should look like.

Things have changed a lot in the last century. In 1915, the first automatic telephone exchange in Australia had just been opened and “Billy” Hughes became our seventh prime minister. He went on to become one of our most colourful, charting a tumultuous course through Australian politics.

A century later we have a new prime minister facing a profoundly different world. Politics is as tumultuous as ever but technology has changed radically, utterly transforming the way we live, the nature of our work, and our health.

The Department of Defense has awarded Orion Health a subcontract to link disparate IT systems and facilitate the interoperability between them as part of the Defense Healthcare Management System Modernization Program.

Orion Health joins the Leidos/Cerner/Accenture team which in July won the DOD's contract to overhaul the military's health records.

Orion Health, a population health management provider, will utilize its Rhapsody Integration Engine to link the DOD's new Cerner EHR system to civilian facilities.

Orion Health has been appointed as the integration and interoperability partner as a member of the Leidos syndicate that has been awarded a major contract by the Department of Defence (DoD) in the United States.

The Leidos Partnership for Defence Health will provide an electronic health record (EHR) off-the-shelf solution, integration activities and deployment across the Military Health System.

The contract, known as the Defence Healthcare Management System Modernisation (DHMSM), is an initiative designed to modernise the military’s healthcare system, enabling patients and clinicians to capture and share health data more efficiently.

New Zealand healthcare technology company Orion Health has signed a strategic new contract in the United Kingdom with Boots, a member of the Walgreens Boots Alliance, a retail pharmacy network.

Terms of the deal will see Orion Health technology utilised to provide a solution that supports community pharmacists in the delivery of in-store clinical services which have previously been provided on paper or in a variety of IT systems.

This capability is increasingly relevant as health economies opt to move care closer to the community, to reduce the burden on acute services, and to offer individuals a community based option for many services.

Silver Chain Group, the not-for-profit organisation that provides home care health services to more than 83,000 patients, has become the surprise source of Telstra’s latest quest to unearth the next great technology.

The Perth-based organisation said yesterday it had struck a deal to sell its EOS Technologies subsidiary to Telstra Health.

Financial details of the deal were not revealed and Silver Chain is not saying how much cash it has pumped into EOS, which developed the ComCare community care management system that is used by the group’s more than 3000 staff and volunteers.

Telstra has announced the appointment of three new group executives, as well as the departure of its Retail group executive Gordon Ballantyne, amid a refocus for the telecommunications provider on "strategic growth".

Karsten Wildberger will be promoted from group managing director of Consumer and acting group managing director of Products to the AU$18 billion portfolio of group executive of Retail; Cynthia Whelan, currently the group managing director of Strategic Finance and acting group executive of International, will be appointed group executive of International and New Businesses; and Joe Pollard will be the new chief marketing officer and group executive of Media, promoted from his present role of group MD of Media and Marketing.

All three will report directly to Telstra CEO Andrew Penn, who said the appointments would help drive the company's agenda for continued strategic growth.

Technology Reporter

Crucial hurdle overcome for quantum computing

The world'™s first calculation using two quantum bits in silicon has been demonstrated by a team of engineers at UNSW Australia. (Vision courtesy UNSW)

Australian scientists have discovered a way to put quantum computing technology into silicon computer chips, paving the way for the first commercial manufacture of the holy grail in superfast computing.

For decades scientists have been trying to turn quantum computing — which allows for multiple calculations to happen at once, making it immeasurably faster than standard computing — into a practical reality rather than a moonshot theory. Until now, they have largely relied on "exotic" materials to construct quantum computers, making them unsuitable for commercial production.

But researchers at the University of New South Wales have patented a new design, published in the scientific journal Nature on Tuesday, created specifically with computer industry manufacturing standards in mind and using affordable silicon, which is found in regular computer chips like those we use every day in smartphones or tablets.

2 comments:

Anonymous
said...

WA Health has finally begun taking applications for a chief information officer role that has remained in the hands of temporary appointees since 2010.

WA Health demonstrates it has had virtually a ZERO commitment to health IT for FIVE years. No wonder we have major project failures everywhere we look - HealthSmart, Royal Adelaide Hospital, Fiona Stanley Hospital, Macquarie Private Hospital, NEHTA, ...

This gives an indication of the minuscule likelihood that the ACeH will have any impact at all.